Provider Demographics
NPI:1083712160
Name:CASELLA, NICOLE FRANCESCA (MS,PT)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:FRANCESCA
Last Name:CASELLA
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 ROUTE 52 STE 12
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1630
Mailing Address - Country:US
Mailing Address - Phone:845-896-3750
Mailing Address - Fax:845-896-5728
Practice Address - Street 1:1505 ROUTE 52 STE 12
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1630
Practice Address - Country:US
Practice Address - Phone:845-896-3750
Practice Address - Fax:845-896-5728
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ07C41Medicare ID - Type Unspecified